Complaint Questionaire

If you feel that you have been discriminated against, fill the form provided below and one of our Enforcement Officer will contact you. 

1. Please indicate the area of discrimination (Employment, Housing, Public Accommodation, Financial Transaction, Other)
   
2. Please indicate the type of discrimination (Race or Color, Religion, National Origin, Sex, Disability, Age (40 and over; employment only), Familial Status (housing only), Retaliation, Smoking)
   
3. Who discriminated against you? Give name and address of the employer, labor organization, employment agency, licensing agency, apprenticeship committee, public accommodation, real estate broker, lender, or apartment manager.
   
4. Identify the actual date or the most recent date on which this discrimination occurred?
   
5. Explain what unfair thing was done to you.